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Antenatal Corticosteroids for Fetal Lung Development

Examples

Generic Name Brand Name
betamethasone Celestone Soluspan
dexamethasone  

How It Works

Betamethasone and dexamethasone cause an immature fetus's lungs to produce a compound called surfactant. A full-term baby's lungs naturally produce surfactant, which lubricates the lining of the air sacs within the lungs. This allows the inner surfaces of the air sacs to slide against one another without sticking during breathing. Premature infants whose lungs have begun producing surfactant are more able to breathe on their own, or with less respiratory treatment, after birth.

Why It Is Used

Betamethasone and dexamethasone are corticosteroids, also called glucocorticoids, that are given before birth (antenatally) to speed up a preterm fetus's lung development. Either is used when a mother is in preterm labor and birth may occur within 7 days. This helps prevent respiratory distress syndrome (RDS) and related complications following premature birth.

Many infants born at 33 to 34 weeks' gestation have sufficient lung maturity to breathe on their own. But considering the low-risk, high-benefit nature of this treatment, corticosteroids are typically used up to 34 weeks of pregnancy.

How Well It Works

Research shows that corticosteroids, when given to the mother during preterm labor, reduce serious problems for the baby who is born preterm.1

Betamethasone or dexamethasone is most effective if delivery occurs at least 24 hours after the first dose of the medicine has been given and less than 7 days after the last dose of the medicine.

Either medicine will benefit a premature newborn by lowering the risk of:

Side Effects

Corticosteroid side effects that might affect the mother include fluid retention and increased blood pressure. But these are short-term side effects and less likely to occur at all during such a short period of treatment. These side effects are more of a concern during long-term treatment for other health problems.

Control of diabetes may be more difficult in pregnant women when corticosteroids are used. Your doctor may recommend a different insulin dose during this time.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Fetal lung maturity testing (using amniotic fluid collected through amniocentesis) is sometimes used to determine whether antenatal corticosteroid treatment is necessary.

A second course of corticosteroids may be given if the mother is still at risk of preterm birth before 34 weeks and if the first course of this medicine was at least 1 week earlier.2

Complete the new medication information form (PDF)new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Haas DM (2011). Preterm birth, search date June 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
  2. American College of Obstetricians and Gynecologists (2012). Management of preterm labor. ACOG Practice Bulletin No. 127. Obstetrics and Gynecology, 119(6): 1308–1317.

Credits

By Healthwise Staff
Sarah Marshall, MD - Family Medicine
William Gilbert, MD - Maternal and Fetal Medicine
Last Revised January 8, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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